Intermittent lowering of cortisol as treatment of clinical conditions associated with abnormal concentrations of cortisol in animals

Abstract

Use of a compound of formula (I) or a 3-enol C 1-4 alkanoate ester thereof in the manufacture of a medicament for the intermittent treatment of a condition of a human or non-human mammal in which said mammal has an abnormally high serum concentration of an adrenal hormone: Wherein R 1 , R 2 , R 5 , and R 6 are the same or different and each is hydrogen or C 1 to 4? alkyl; R 3 is hydrogen C 1 to 4? alkyl, C 1 to 4? alkenyl or C 1 to 4? alkynyl; R 4 is hydroxy, C 1 to 4? alkanoyloxy, a group of formula (II) or (III) Wherein R 7 is (CH 2 ) n , where n is an integer of from 0 to 4, R 8 is hydrogen, C 1 to 4? alkyl, hydroxy or NH 2 and R 9 and R 10 are the same or different and each is hydrogen or C 1 to 4? Alkyl; or R 3 and R 4 together are oxo, ethylenedioxy or propylenedioxy. The invention has practical benefits for the treatment of man and other animals with diseases associated with abnormal production of adrenal steroids. The invention also shows that sustained suppression of the adrenal hormones is not required to achieve relief of symptoms in these conditions.

The invention claimed is:  
     
       1. A method for treating hyperadrenocorticism in a dog comprising administering to the dog an initial once daily dosage of up to 10 mg/kg of trilostane, carrying out an ACTH stimulation test on said dog wherein the post-ACTH stimulation test cortisol concentration of said dog is measured, and administering an increased or twice daily dosage of trilostane to said dog having a post-ACTH stimulation test cortisol concentration greater than 220 nmol/L. 
     
     
       2. The method of  claim 1 , comprising conducting the ACTH stimulation test every ten days to three months during treatment. 
     
     
       3. The method of  claim 1 , comprising conducting the ACTH stimulation test every ten days, four weeks, three months or six months during treatment. 
     
     
       4. The method of  claim 1 , comprising conducting the ACTH stimulation test every three months during treatment.